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23D-123
BP-2024-0305 184 FEDERAL ST COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 23D-123-001 CITY OF NORTHAMPTON Permit: Alts Renovations Repair PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) BUILDING PERMIT Permit# BP-2024-0305 PERMISSION IS HEREBY GRANTED TO: Project# SUNROOM 2024 Contractor: License: INTEGRITY DEVELOPMENT & Est.Cost: 72700 CONSTRUCTION INC 090514 Const.Class: Exp.Date: 09/12/2024 Use Group: Owner: FARLOW WINN STEVEN A&LESLEY Lot Size (sq.ft.) INTEGRITY DEVELOPMENT &CONSTRUCTION Zoning: URB Applicant: INC Applicant Address Phone: Insurance: 110 PULPIT HILL RD (413)549-7919 WMZ80080062242021 AMHERST,MA 01002 ISSUED ON: 03/22/2024 TO PERFORM THE FOLLOWING WORK: ALTERATIONS TO BACK PORCH TO CREATE SUNROOM POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector Underground: Service: Meter: Footings: Rough: Rough: House# Foundation: Final: Final: Final: Rough Frame: Gas: Fire Department Driveway Final: Fireplace/Chimney: Rough: Oil: Insulation: Smoke: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Signature: /e/2" Fees Paid: $473.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Office of the Building Commissioner clodw/u vi €-(A 114 p,3 The Common 1 t4f/t sachuse?ts L r Board of Building RegulationsW Standards FOR VYl Massachusetts Stak-IRtading Code, 780 CMR MUNIUSE LITY Building Permit Application To Construct'T ai�' Renovate Or Demolish a Revised Mar 2011 One-or Two-Farnilyf velltiz , a / This Section For Official Use Only Building ''Permit Number.JJ�-1217-",_J S Date Applied: 4-1./ � ,, -, 3-22-7zy Building Official(Print Name) Signature Date SECTION 1:SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map& Parcel Numbers 184 Federal Street,Florence,MA 01062 23D 23D-123-001 1.1 a Is this an accepted street?yes X no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: URB Same s 53,237 sq ft 117 ft Zoning District Proposed Use Lot Area(sq ft) Frontage(ft) 1.5 Building Setbacks(ft) Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided 10 N/A No Change 15 NO.No Change 20 N/A No Change 1.6 Water Supply: (M.G.I.c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public Private❑ Zone: _ Outside Flood Zone? MunicipaIXOn site disposal system 0 Check ifyes2 SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: WINN STEVEN A&LESLEY FARLOW Florence, MA,01062 Name(Print) City,State,ZIP 184 Federal Street 413-320-3272 lesleyfarlow115@gmail.com No.and Street Telephone Email Address SECTION 3: DESCRIPTION OF PROPOSED WORK2 (check all that apply) New Construction 0 Existing Building Gil Owner-Occupied a Repairs(s) B Alteration(s) 0 Addition 0 Demolition 0 Accessory Bldg. 0 Number of Units Other 0 Specify: Brief Description of Proposed Work2: Alterations to the back porch area to create an all season sunroom.Re-framing walls to replace screens with windows. Installing foam board insulation to full depth of new floor&exterior wall cavity. Replacing existing stairs, landing,balusters and handrails. Installing 2 new doors.Installing a new mini split,electric baseboard heat. SECTION 4: ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1. Building $60,000 1. Building Permit Fee: $ Indicate how fee is determined: 2. Electrical $4,000 0 Standard City/Town Application Fee 0 Total Project Costa(Item 6)x multiplier x 3. Plumbing $0 2. Other Fees: $ _ 4. Mechanical (11VAC) $g 700 Ltst:_ 5. Mechanical (Fire $ Suppression) 0 Total All Fees;$ �j Check No.019 1 Check Amount: W 7�---Cash Amount: 6. Total Project Cost: $72 700 0 Paid in Full 0 Outstanding Balance Due:, cit Call ,3i, FM i �A..y g r7/ v a SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) CS-090514 09/12/2024 Anna Cook License Number Expiration Date Name of CSL Holder List CSL Type(see below) U 113 January Hills Road No.and Street Type Description Amherst, MA,01002 U Unrestricted(Buildings up to 35,000 cu.ft.) wn,State,ZIP — R Restricted 1&2 Family Dwelling City/ToM Masonry RC Roofing Covering WS Window and Siding SF Solid Fuel Burning Appliances (413) 374-2322 Cook@integbuild.com I Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) 118041 01/19/2025 INTEGITY DEVELOPMENT AND CONSTRUCTION,INC. HIC Registration Number Expiration Date HIC Company Name or HIC Registrant Name 110 PULPIT HILL ROAD info©integbuild.com No.and Street Email address AMHERST,MA,01002 (413)549-7919 City/Town,State,ZIP Telephone SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.152.§ 25C(6)) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the Issuance of the building permit. Signed Affidavit Attached? Yes X No .0 SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I,as Owner of the subject property,hereby authorize Integrity Development&Construction to act on my 4Cry, beh f,in all matters relative to work authorized by this building permit application. '. , FFlt2taw 3/iiti 21 Print ner's3ame(Electronic Signature) Date SECTION 7b:OWNERS OR AUTHORIZED AGENT DECLARATION By ni tering anie below,I hereby attest under the pains and penalties of perjury that all of the information co tain d' thi application is true and accurate to the best of my knowledge and understanding. l.I y FY-12(0 v 3)Ii/zK Print Own s or Authorized Agent's Name(Electronic Signature) Date NOTES: 1. An Owner who obtains a building permit to do his/her own work,or an owner who hires an unregistered contractor (not registered in the Home Improvement Contractor(HIC)Program),will not have access to the arbitration program or guaranty fund under M.G.G.c. 142A.Other important information on the HIC Program can be found at www.mass.gov/oca Information on the Construction Supervisor License can be found at www.mass.gov/dps 2. 'When substantial work is planned,provide the information below: Total floor area(sq.ft.) (including garage,finished basement/attics,decks or porch) Gross living area(sq.ft.) Habitable room count Number of fireplaces Number of bedrooms Number of bathrooms Number of half/baths Type of heating system Number of decks/porches Type of cooling system ___ Enclosed Open 3. "Total Project Square Footage"may be substituted for"Total Project Cost" City of Northampton tHAN ,\ s ,{ Massachusetts �w� 'i * G. r(' N 3k is DEPARTMENT OF BUILDING INSPECTIONS s i ,71 212 Main Street • Municipal Building N Northampton, MA 01060 4'1* '')V.‘ CONSTRUCTION DEBRIS AFFIDAVIT (FOR ALL DEMOLITION AND RENOVATION PROJECTS) In accordance of the provisions of MGL c 40, 554, a condition of Building Permit Number is that all debris resulting from this work shall be disposed of in a properly licensed waste disposal facility, as defined by MGL c 111, S 150A. The debris will be disposed of in: Location of Facility: S & G Recycling, 9 Shoham Road, East Windsor, CT The debris will be transported by: Name of Hauler: Dave Wickles Trucking Signature of Applicant: 4r a- Date: 3/14/2024 r The Commonwealth of Massachusetts i ' Department of Industrial Accidents �i2 1 Congress Street,Suite 100 ;?? Boston, MA 02114-2017 wwn:ntass.govldio ltitrakers'('aanipensatian Insurance Aflidttv it:1#uit3aiers.f'semiactnrs Elcctriciau: P'himbers. TO BE 1 ILE,0 wrrn TM:PEkmurftNt:At"T'lHOREIN. .sontieant Inform a tin tt Please Print Legibly Name i nusinessttrantration.Individual): Integrity Development&Construction A Address: 110 Pulpit Hill Road City/State/Zip:M Amherst,_MA 01002 Phone#: (413) 549-7919 Are,ern air employer?Cheek the appropriate ttux: Type of project(required): .►.."<1 am a empltryer with 12 erriployasen thin and or part-direct.' 7. 0 New construction 20 I war a>ule}rruprwtor or partnership and have ant empteyea-.%urkung fur roc in S. Remodeling ally capacity.(Nu avrkera'comp.urruracru: required.) 9. Demolition S 1 our a hunre,awrter doing all work myself.Nov.o trait.'comp.irr,uru ct required.) I U 0 Building addition S.El I am a Iwrmatwatt and will he hirurg contra:turs to evaded all work on my property. I will gayer that all contractors either have occrrkrrY ecxntaetrrataom ur+ur iFICC or tare sole 11 -4 Electrical rCpairsi or additions proprictora w irk no tinploycen 12.0 Plumbing repairs or addititms t I am a mum)contractor and I ha%c Aired the sib-crertractort hated on the at€uetwil street. 'ibis:.>ub-emit:actor.Isase employee.nailIsav�ewurler.€' ump.iu.,waner. i Rootrepaers 6.0 We arc r°urporarieun and an;Aileen hay a exercised their nght tit exemption per httiL c. 1 0tEte1 152,...r 114I..,arid o,r hew no tri plut'eca.[No t4 ur li era'camp.insurance required.] ".Any applicant that dnt ka but t<1 traaat alau till out the seetirrn below Aim.Mg.their wurhera'cuurpcnsatiun policy inionnutiun. itamrrsanrm tithe submit this affidavit iridreatrntg they arc thong all nark and then hire°tiesiae contra;tur*mint..ubmrt a new uitirin.,it Indicating si.•i, Cuntratturs that cheek thra box mint attacked an additional Ahem show ine,the name of the su'b-canttw art.anti state in lwttrrr or not ilium:tannic,tvi eerrpluveer If tla:nth-r:untraeturs have employees.dray roust pre.s idt their workers-cramp.polity mother. r.. I am an employer that is providing workers'compensation insurance,for my employees, Below is the policy and fob site information. Insurance Company Name: A.I.M. Mutual/A.I.M. —. Palicv#or Sett-ins.Lie.t#: WMZ80080062242023A Expiration Date: 04/10/2024 Job Site Address: 184 Federal Street City'State,'Zip: Florance, MA 01062 Attach a copy of the t►urkers'coontpensation polio'declaration page(showing the policy number and expiration date). Failure to secure coverage as riquiictl tinder M L c. 152.§25A is a criminal violation punishable by a tine up to 51,500.00 andlor one-year imprisonment.as well as civil penalties in the faun of a STOP WORK ORDER and a fine of up to S250.OD a day against the violator_A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage,verification. !do hereby certify under the pains and penalties of perjury that the infiaeration print led abate is tries and correct. Sitrnaturc: 41f-At.2 elfrB/‘ oak,: 3/14/2024 [Tarn:#:(413) 374-2322 !heal use only. Do not write in this area,to he completer!by city or town official. City or Town: Permit'Licentte it Issuing Authority(click one): 1. Board of Health 2.Building[Department 3.t'itylTn wn Clerk 4.Electrical Inspector S.Plumbing Inspector 6,Other Contact Person: Phone t: fr City of Northampton s w"� SI '+ss` < Massachusetts w- 3. . 4; DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street • Municipal Building Northampton, MA 01060 HOMEOWNERS'EXEMPTION ELIGIBILITY AFFIDAVIT L&SL.(; iti ,2LC (9s-y '( �7U J` (insert full legal name), born (inset month, day,year),hereby depose and state the following: 1. I am seeking a building permit pursuant to the homeowners' exemption to the permit requirements of the Massachusetts State Building Code, codified at 780 CMR 110.R5.1.3.1, in connection with a project or work on a parcel of land to which I hold legal title. 2. I am not engaged in,and the project or work for which I am seeking the aforementioned homeowners'exemption, does not involve the field erection of manufactured buildings constructed in accordance with 780 CMR 110.R3. 3. I qualify under the State Building Code's definition of"homeowner"as defined at 780 CMR 110.R5.1.2: Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be, a one-or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a home owner. 4. I do not hold a valid Massachusetts construction supervision license and, except to the extent that I qualify for and will abide by the Massachusetts State Building Code's requirements for the supervision of the project or work on my parcel, I am not engaged in construction supervision in connection with any project or work involving construction, reconstruction, alteration, repair, removal or demolition involving any activity regulated by any provision of the Massachusetts State Building Code. 5. If I engage any other person or persons for hire in connection with the aforementioned project or work on my parcel,I acknowledge that I am required to and will act as the supervisor for said project or work. Signed under the pains nd penalties of perjury on this I Ll day of M(VC , 20.I. (Signature)